Emergency Room Reliance Examined in Adolescents

Young children and those with special needs less likely to have high emergency department reliance

By Eric Metcalf

HealthDay Reporter

TUESDAY, Dec. 15 (HealthDay News) -- Emergency department reliance (EDR), the percentage of health care visits occurring in the emergency department (ED), may provide information on whether children who are frequent ED users lack sufficient access to primary care, according to research published online Dec. 14 in Pediatrics.

Eric L. Kroner, M.D., of the Children's Research Institute in Milwaukee, and colleagues analyzed data from 8,823 children younger than 18 years of age involved in two two-year Medical Expenditure Panel Survey cohorts. The authors defined frequent ED use as two or more visits and high EDR as greater than 0.33.

The researchers found that young children and those with special health needs were more likely to use the ED for care, but were less likely to have a high EDR, suggesting that they didn't visit the ED as an excessive proportion of their general health care use. Those with less parental education, low income, of African-American race, and utilizing public insurance were more likely to have high EDR.

"In this first large descriptive study, EDR was shown to discriminate between children who are frequent users of the ED. EDR, readily calculated from data contained in large administrative databases, can be used as a complementary measure of ED use to differentiate populations with increased need for ED services from those with lack of access to quality primary care," the authors conclude.